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Seattle Post-Intelligencer (US), August 23, 2007

Judgmental pharmacists put people's
health at risk


This is not a prescription for fast, fast, fast relief.

First, the Food and Drug Administration dragged its feet for years, through at least three administrators, before approving the Plan B "morning-after" pill.

Then the Washington State Pharmacy Board muddled around, opposing, then reversing its opposition to requiring pharmacists to dispense legal prescriptions that they may personally oppose for "moral reasons."

Then objecting pharmacists sued, saying the ruling overrides their religious rights.

Now, backed by Planned Parenthood, the American Civil Liberties Union and the Northwest Women's Law Center, individual patients, a physician and assorted worried womenfolk are countersuing, saying access to any number of crucial medicines may be at stake.

It's enough to give you a migraine, if you thought you could still get a pill.

The suit is not just about Plan B. If you say pharmacists have a right to "follow their consciences" in refusing medications, it's a precedent and a darned scary one. So says former state Superintendent of Public Instruction Judith Billings, who, for a dozen years has been living with HIV. She is one of the parties in the countersuit.

"Some people still believe that, if you have HIV or AIDS, you must be a terrible person, so, sorry, but I'm not going to fill this prescription even though you and your doctor agree it's what you need," she told me this week.

It's chilling, Billings says. "Frankly, if a woman didn't get Plan B and an egg did implant, there are other, if lesser options. But the HIV virus is one of the most horrible, because it mutates every time it replicates," she says.

If you are on a particular class of HIV drugs and you become resistant to even one drug in that class of up to five separate medications, you are putting someone at mortal risk if you deny or even delay just one of their medical options.

People in this pill-popping culture can be blasé about meds. Forget one? You can take it later. But not with HIV. In fact, not even with Plan B, if it's to be truly effective.

HIV drugs must be taken on schedule. Once their half-life has passed, the virus shifts into overdrive to overtake that particular drug. Then, the more resistant to a given drug one gets, the more critical the need to keep meds available.

And, should a condom fail, a non-HIV partner would need immediate drug access.

But there are still pharmacists who won't stock those drugs because they think people with HIV don't deserve the best medical care. Billings serves on two national AIDS boards, and she hears such stories all the time.

Although she mostly gets her drugs online, there have been screw-ups, and, in beating the bushes for Puyallup-area pharmacies that carry what she needs, she has had to scour two and three stores to find it. "It was scary," she says.

Billings has also seen "that look" in the eyes of a white coat who, she says, was "dying to ask" how she contracted HIV. Sex? Drugs? (She got it from a blood transfusion. But does that -- should that -- matter?)

And there are pharmacies that won't stock HIV drugs, saying they don't have a large enough clientele to justify the expense.

"But any pharmacy should have the ability to get them quickly rather than have you run around looking," Billings said. "The whole point of a pharmacy is to provide the medication people require to survive."

Plus, assumptions, she says, can be deadly. Take the experience of a young, tattooed and pierced man in Yakima who was refused syringes prescribed for his diabetes injections because the pharmacist wouldn't give needles to a "druggie."

Catherine Rosman is another of the seven people joining the lawsuit. She is a married graduate student, a member of the Methodist Church and of Spiritual Youth for Reproductive Freedom, just in case you need to know.

She says she is pro-choice by faith. That she believes God gave people the freedom to make their own choices in life. And that refusing Plan B, or any other legally prescribed medication, is not love, not respect and not treating a woman as a full adult.

"Nobody really knows where a woman is coming from, or if she was raped the night before," Rosman said. "Plan B might be the healthiest option for her, and she ought to be able to get it without God punishing her or being mad at her."

Often, from friends and fellow students, Rosman hears stories of scolding and refusal by pharmacists. Druggists who ask young women, "Are you sure you know what you're doing? Or, "Do you really want this?"

It took one friend two hours of seemingly needless waiting to get a Plan B prescription filled. It was hard to imagine any other explanation, Rosman said, than that the obviously disapproving pharmacist was stalling so the woman would go somewhere else.

This stuff simply must stop. If some tongue-clucking, finger-wagging pharmacist stood between a man and his Viagra, there would be big-rig tire tracks up the back of a starched white coat.

Irksome as it is, the current counterlawsuit beats climbing over a pharmacy counter for a little forcible on-site compliance.

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